METHOD FOR EVALUATING EFFECTIVENESS OF SIMULATION TRAININGS IN SURGICAL MANIPULATIONS

Abstract


Performance of varies surgical manipulations (SM) is a key skill in surgery. To develop such skills simulation trainings (ST) are used, followed by a training transfer, which is the ultimate goal of ST However, this training goal is not always achievable — the share of doctors using laparoscopic intracorporal suturing after the training ranges from 43.8% to 72.2%. Therefore, to improve training transfer it is necessity to evaluate effectiveness of such training programs. Current methods evaluate training results either outside real practice or in practice but in small groups due to high cost and efforts consumed. The paper presents a new method to evaluate effectiveness of SM simulation training programs in general population of the trainees, evaluate additional effects of the training and analyze personal factors affecting the training results. The method is based on a survey of the ST program participants, and tested at the Training and Accreditation Center «Medical Simulation Center of the Botkin Hospital» within the program on laparoscopic intracorporal suturing. The rate of training transfer added up to 88.9%. The suggested method makes it possible to evaluate effectiveness of SM simulation training in general population of the trainees, analyze factors affecting the training results and use findings for improving ST programs and methods in general. The method can be recommended for a large-scale implementation in simulation training programs.

About the authors

A. V. Shabunin

Botkin Hospital, 125284, Moscow, Russia

A. V. Logvinov Yu. I. Klimakov

Botkin Hospital, 125284, Moscow, Russia; Botkin Hospital, 125284, Moscow, Russia

R. Yu. Maer

Botkin Hospital, 125284, Moscow, Russia; Research Institute for Healthcare Organization and Medical Management, 115088, Moscow, Russia

References

  1. Симуляционное обучение в хирургии / под ред. В. А. Кубышкина, С. И. Емельянова, М. Д. Горшкова. М.; 2014. 264 с.
  2. Шабунин А. В., Логвинов Ю. И. Симуляционное обучение. Руководство. М.; 2018. 792 с.
  3. Mattar S. G., Alseidi A. A., Jones D. B. et al. General surgery residency inadequately prepares trainees for fellowship: results of a survey of fellowship program directors // Ann. Surg. 2013. Vol. 258, N 3. P. 440—449. doi: 10.1097/SLA.0b013e3182a191ca
  4. Mereu L., Carri G., Albis Florez E. D., et al. Three-step model course to teach intracorporeal laparoscopic suturing // J. Laparoendosc. Adv. Surg. Tech. A. 2013. Vol. 23, N 1. P. 26—32. doi: 10.1089/lap.2012.0131
  5. Профессионально-педагогические понятия: словарь / под ред. Г. М. Романцева. Екатеринбург; 2005. 444 с.
  6. Kirkpatrick D., Kirkpatrick J. Evaluating training programs: the four levels. San Francisco; 2006. 392 p.
  7. Шабунин А. В., Климаков А. В., Логвинов Ю. И. Подходы к оценке эффективности обучения навыкам лапароскопического интракорпорального шва // Московский хирургический журнал. 2021. Специальный выпуск.
  8. Шабунин А. В., Климаков А. В., Логвинов Ю. И., Маер Р. Ю. Способ оценки эффективности симуляционного обучения лапароскопическому интракорпоральному шву // Здоровье мегаполиса. 2023. Т. 4, Вып. 2. С. 15.
  9. Khan M. R., Shariff A. H., Nasim S. et al. Effectiveness of Laparoscopic Skills Workshop on Enhancing Knowledge and Skills of Surgical Residents and Its Comparison with DOPS (Direct Observation of Procedural Skills) Scores: Prospective Cohort Study // Med. Sci. Educ. 2020. Vol. 30, N 2. P. 861—867. doi: 10.1007/s40670-020-00966-5
  10. Lynagh M. A systematic review of medical skills laboratory training: where to from here? // Medical education. 2007. Vol. 41. P. 879—887.
  11. Memon M. A., Brigden D., Subramanya M. S., Memon B. Assessing the surgeon's technical skills: analysis of the available tools // Acad. Med. 2010. Vol. 85, N 5. P. 869—880. DOI: 10.1097/ ACM.0b013e3181d74bad
  12. Oropesa I., Sánchez-González P., Lamata P. et al. Methods and tools for objective assessment of psychomotor skills in laparoscopic surgery // J. Surg. Res. 2011. Vol. 171, N 1. P. e81—e95. doi: 10.1016/j.jss.2011.06.034
  13. Pellen M., Horgan L., Roger Barton J., Attwood S. Laparoscopic surgical skills assessment: can simulators replace experts? // World J. Surg. 2009. Vol. 33, N 3. P. 440—447. doi: 10.1007/s00268-008-9866-4
  14. Porte M. C., Xeroulis G., Reznick R. K., Dubrowski A. Verbal feedback from an expert is more effective than self-accessed feedback about motion efficiency in learning new surgical skills // Am. J. Surg. 2007. Vol. 193, N 1. P. 105—110. doi: 10.1016/j.amjsurg.2006.03.016
  15. Shepherd W., Arora K. S., Abboudi H. et al. A review of the available urology skills training curricula and their validation // J. Surg. Educ. 2014. Vol. 71, N 3. P. 289—296. doi: 10.1016/j.jsurg.2013.09.015
  16. Spiliotis A. E., Spiliotis P. M., Palios I. M. Transferability of simulation-based training in laparoscopic surgeries: a systematic review // Minim. Invasive Surg. 2020. Vol. 2020. P. 5879485. doi: 10.1155/2020/5879485
  17. Varas J., Mejía R., Riquelme A. et al. Significant transfer of surgical skills obtained with an advanced laparoscopic training program to a laparoscopic jejunojejunostomy in a live porcine model: feasibility of learning advanced laparoscopy in a general surgery residency // Surg. Endosc. 2012. Vol. 26, N 12. P. 3486—3494. doi: 10.1007/s00464-012-2391-4
  18. Kolozsvari N. O., Kaneva P., Brace C. et al. Mastery versus the standard proficiency target for basic laparoscopic skill training: effect on skill transfer and retention // Surg. Endosc. 2011. Vol. 25, N 7. P. 2063—2070. doi: 10.1007/s00464-011-1743-9
  19. Boud D. Avoiding the traps: Seeking good practice in the use of self-assessment and reflection in professional courses // Social Work Education. 1999. Vol. 18, N 2. P. 121—132.
  20. Davis D. A., Mazmanian P. E., Fordis M. et al. Accuracy of physician self-assessment compared with observed measures of competence: a systematic review // JAMA. 2006. Vol. 296, N 9. P. 1094—1102. doi: 10.1001/jama.296.9.1094
  21. Ganni S., Chmarra M. K., Goossens R. H.M., Jakimowicz J. J. Self-assessment in laparoscopic surgical skills training: Is it reliable? // Surg. Endosc. 2017. Vol. 31, N 6. P. 2451—2456. doi: 10.1007/s00464-016-5246-6
  22. Peyre S., MacDonald H., Al-Marayati L. et al. Resident self-assessment versus faculty assessment of laparoscopic technical skills using a global rating scale // International Journal of Medical Education. 2010. Vol. 1. P. 37—41. doi: 10.5116/ijme.4bf1.c3c1
  23. Schoeb D. S., Brennecke E., Andert A. et al. Assessment of a course of realistic surgical training during medical education as a tool for pre-residential surgical training // BMC Med. Educ. 2016. Vol. 16. P. 45. doi: 10.1186/s12909-016-0568-6
  24. Fahim C., Wagner N., Nousiainen M. T., Sonnadara R. Assessment of technical skills competence in the operating room: a systematic and scoping review // Acad. Med. 2018. Vol. 93, N 5. P. 794—808. doi: 10.1097/ACM.0000000000001902
  25. Mitchell E. L., Arora S., Moneta G. L. et al. A systematic review of assessment of skill acquisition and operative competency in vascular surgical training // J. Vasc. Surg. 2014. Vol. 59, N 5. P. 1440—1455. doi: 10.1016/j.jvs.2014.02.018
  26. Dawe S. R., Windsor J. A., Broeders J. A. et al. A systematic review of surgical skills transfer after simulation-based training: laparoscopic cholecystectomy and endoscopy // Ann. Surg. 2014. Vol. 259, N 2. P. 236—248. doi: 10.1097/SLA.0000000000000245
  27. Vassiliou M. C., Feldman L. S., Andrew C. G. et al. A global assessment tool for evaluation of intraoperative laparoscopic skills // Am. J. Surg. 2005. Vol. 190, N 1. P. 107—113. doi: 10.1016/j.amjsurg.2005.04.004
  28. Crochet P., Agostini A., Knight S. et al. The performance gap for residents in transfer of intracorporeal suturing skills from box trainer to operating room // J. Surg. Educ. 2017. Vol. 74, N 6. P. 1019—1027. doi: 10.1016/j.jsurg.2017.05.013

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